Luxitaa Goenka1, Melvin George2, Balakrishnan Karthikeyan3
BACKGROUND
Nicorandil in conjunction with Percutaneous Coronary Intervention (PCI) has shown to improve the coronary reflow. It is not known if use of Nicorandil could lead to improvement in short and long-term cardiovascular outcomes.
MATERIALS AND METHODS
Literature evaluation was done to determine the efficacy of Nicorandil in improving the cardiovascular outcomes in Acute Myocardial Infarction (AMI) patients in the setting of PCI. The search terms used were Nicorandil and AMI and PCI using MEDLINE and Science Direct.
Study Design- A systematic review and meta-analysis.
RESULTS
Thirteen randomised clinical trials were identified. Nicorandil significantly reduced in-hospital outcomes (RD: 0.16; 95%, CI: -0.23 to -0.09; I2: 95%; p<0.00001; FE model). There was a reduction in the number of patients with thrombolysis in myocardial infarction (TIMI flow ≤2) grade (RD: 0.06; 95%, CI: -0.09 to -0.02; I2: 95%; p=0.002; FE model). There was no significant difference in the major adverse cardiovascular events between Nicorandil and controls when assessed between 30 days to 8 months after discharge.
CONCLUSION
While Nicorandil clearly appears to have a benefit in improving in-hospital cardiovascular outcomes, it remains to be seen if this could translate into improved long-term cardiovascular outcomes.
